Asrs scale
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Understanding the ASRS Scale: A Comprehensive Overview
Introduction to the ASRS Scale
The Adult ADHD Self-Report Scale (ASRS) is a widely used tool designed to screen for Attention-Deficit/Hyperactivity Disorder (ADHD) in adults. Developed in collaboration with the World Health Organization (WHO), the ASRS aims to provide a reliable and efficient method for identifying ADHD symptoms based on the DSM-IV criteria . The scale includes both an 18-item full version and a shorter 6-item screener, each serving distinct purposes in clinical and community settings.
Development and Structure of the ASRS
Full ASRS (18-Item Version)
The full ASRS consists of 18 questions that assess the frequency of ADHD symptoms as outlined in the DSM-IV Criterion A. This comprehensive version is designed to capture a wide range of symptoms and provide a detailed profile of an individual's ADHD-related behaviors . The Italian translation of the ASRS-18 has shown robust construct validity and diagnostic accuracy, making it effective for screening ADHD in community-dwelling adolescents .
ASRS Screener (6-Item Version)
The ASRS Screener is a condensed version of the full ASRS, comprising six questions selected through stepwise logistic regression to optimize concordance with clinical diagnoses. This shorter version has demonstrated higher sensitivity (68.7% vs. 56.3%) and specificity (99.5% vs. 98.3%) compared to the full ASRS, making it a preferred tool for quick screening in both community surveys and clinical settings 12.
Psychometric Properties and Reliability
Internal Consistency and Test-Retest Reliability
The ASRS Screener has shown strong internal consistency reliability, with scores ranging from 0.63 to 0.72, and test-retest reliability with Pearson correlations between 0.58 and 0.77 . In non-ADHD controls, the ASRS Screener demonstrated high test-retest reliability, with significant correlations for total scores and individual items, confirming its stability over time .
Validity Across Different Populations
The ASRS has been validated in various populations, including health plan members, adolescents, and substance use disorder (SUD) patients. In a representative sample of health plan members, the ASRS Screener showed strong concordance with clinician diagnoses, with an area under the receiver operating characteristic curve (AUC) of 0.90 . Among SUD patients, the ASRS demonstrated high sensitivity (0.84) and specificity (0.66), making it a reliable tool for identifying ADHD in this population .
Application in Specific Populations
College Students
The ASRS has proven useful in documenting ADHD symptoms and impairment among college students. Studies have shown moderate to good congruency between different modalities of the ASRS administration, such as telephone interviews and paper versions. The ASRS self-report was significantly related to measures of executive functioning and everyday cognitive failure, highlighting its utility in academic settings .
Adolescents
Initial evidence supports the reliability and validity of the ASRS Screener in adolescent community samples. This makes it a valuable tool for large-scale surveys monitoring ADHD symptoms among adolescents, providing a brief and accessible assessment method .
Conclusion
The ASRS, in both its full and screener versions, is a reliable and valid tool for screening ADHD in various populations. Its strong psychometric properties, ease of use, and ability to discriminate between ADHD cases and non-cases make it an essential instrument in both clinical and community settings. Future research should continue to explore its application across different cultures and patient profiles to further validate its effectiveness.
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